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Review Article D-Tagatose Is a Promising Sweetener to Control Glycaemia: a New Functional Food

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Review Article D-Tagatose Is a Promising Sweetener to Control Glycaemia: a New Functional Food Hindawi BioMed Research International Volume 2018, Article ID 8718053, 7 pages https://doi.org/10.1155/2018/8718053 Review Article D-Tagatose Is a Promising Sweetener to Control Glycaemia: A New Functional Food Marion Guerrero-Wyss ,1 Samuel Durán Agüero ,1 and Lisse Angarita Dávila2 1 Escuela de Nutricion,FacultadCienciasDeLaSal´ ud, Universidad San Sebastian,´ Santiago, Chile 2Carrera de Nutricion,FacultaddeMedicina,UniversidadAndresBello,SedeConcepci´ on,´ Talcahuano, Chile Correspondence should be addressed to Marion Guerrero-Wyss; [email protected] Received 27 June 2017; Revised 9 November 2017; Accepted 13 December 2017; Published 9 January 2018 Academic Editor: Konstantinos Papatheodorou Copyright © 2018 Marion Guerrero-Wyss et al. Tis is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Te objective of the current research was to review and update evidence on the dietary efect of the consumption of tagatose in type 2 diabetes, as well as to elucidate the current approach that exists on its production and biotechnological utility in functional food for diabetics. Articles published before July 1, 2017, were included in the databases PubMed, EBSCO, Google Scholar, and Scielo, including the terms “Tagatose”, “Sweeteners”, “Diabetes Mellitus type 2”, “Sweeteners”, “D-Tag”. D-Tagatose (D-tag) is an isomer of fructose which is approximately 90% sweeter than sucrose. Preliminary studies in animals and preclinical studies showed that D-tag decreased glucose levels, which generated great interest in the scientifc community. Recent studies indicate that tagatose has low glycemic index, a potent hypoglycemic efect, and eventually could be associated with important benefts for the treatment of obesity. Te authors concluded that D-tag is promising as a sweetener without major adverse efects observed in these clinical studies. 1. Introduction great interest in the scientifc community [5]. Te pro- posed action mechanism may involve interference in the D-Tagatose (D-tag) is an isomer of fructose which is approx- absorption of carbohydrates through inhibition of intestinal imately 90% sweeter than sucrose. Fructose that corresponds disaccharidases and glucose transportation. It can also act toanaturalhexosewasdevelopedasalow-caloriesugar through the inhibition of hepatic glycogenolysis [1]. In substitute. addition to presenting an efect in the reduction of total Only 20% of the orally ingested tagatose is metabolized cholesterol, VLDL, and LDL compared with sucrose [6], completely and mainly in the liver [1]. In 2001, D-tag was likewise D-tag has contributed to increasing levels of HDL appointed by the Food and Drug Administration (FDA) as a cholesterol [7]. generally recognized safe product (GRAS), and subsequently Te D-tag would have an antihyperglycemic potential it has been used as a nutritional sweetener or low in calories through its benefcial efects on the increment of postprandial [2]. Afer this, the European Union (EU) introduced D-tag serum glucose and hyperinsulinemia. Recent studies indicate as a “new food ingredient,” without any restrictions on the that tagatose has a powerful antidiabetic efect and could amount to be used [1, 2]. eventually be associated with important benefts for the Currently, D-tag is used as a sweetener in beverages, treatment of obesity. However, preliminary results of a study yogurt, creams, and dietetic candy [3]. indicated that there were not any changes in glucose or A method for the mature production of D-tag is the direct insulin levels afer oral administration of D-tag while fasting isomerization of G-galactose in D-tag, with metal hydroxides [8]. such as chemical catalysts in basic conditions [4]. Teobjectiveofthisresearchistoreviewandupdate Preliminary animal studies and preclinical studies evidence about the therapeutic efect of the consumption showed that D-tag decreased glucose levels, generating of tagatose in patients with diabetes type 2 as well as to 2 BioMed Research International Table 1: Antihyperglycemic efect of D-tagatose. Mechanism described or Sample population Methodology Findings proposed Te glucose area under the curve (AUC) was reduced signifcantly also D-Tagatose directly inhibits Tey were given 75 g of glucose, 75 g of by pretreatment with D-tag in a Normal subjects and theabsorptionofglucose D-tag, or 75 g of D-tag 30 min prior to dose-dependent manner in patients type 2 diabetics patients. by intestinal a 75 g oral glucose tolerance test. with diabetes mellitus (� < 0.05 for disaccharidases. 10 g D-tag, � < 0.001for20gD-tag, and � = 0.0001 for 30 g D-tag) [8]. Tey were given D-tag in three treatment groups: 2.5 g, 5.0 g, and 7.5 g Only the 7.5g dosage group exhibited Inhibition of sucrose given orally (three times daily, reductions of fasting glucose from Type 2 diabetics patients. activity by D-tag has been immediately prior to meals). Eight baseline at the 3- and 6-month time in rabbit small intestine. weeks afer screening and stabilization points [1]. of diabetics. D-Tagatose signifcantly reduced Unlike many other diabetes HbA1c compared to placebo. Two randomized groups were given a drugs, the longer the D-Tagatose was efective at reducing dose of D-tag (15 g) and the other D-tagatose therapy, the the HbA1c level when administered for Type 2 diabetics patients. group was given a dose of placebo better the efcacy, since the two months at doses of 15 g TID. (1.5 g), which were dissolved in 125 to intestinal mucosa will be Also signifcant reductions in the 250 ml of water three times a day (TD). exposed for a longer period HbA1c level at six and ten months to D-tag. were also met [9]. elucidate the current approach that exists on its production beverage with tagatose (5 g), only hyperglycemic individuals and biotechnological use in functional food for diabetics. had a signifcant reduction of blood glucose at 120 min (� = 0.019), as well as in the blood glucose area under 2. Methodology the curve (AUC) (� = 0.017)[1].Normalindividualswho received a high dose of the beverage with tagatose (10 g) Articles published before July 1, 2017, were selected for the showed decreased levels of serum insulin, AUC of insulin, completion of this review; the search was carried out in and C-peptide. Terefore, these results suggest that a bever- thedatabasesPubMed,EBSCO,GoogleScholar,andScielo, age sweetened with tagatose could control the postprandial including terms or key words “Tagatose”, “Sweeteners”, “Dia- glycemic response in individuals with hyperglycemia [1]. betes Mellitus type 2”, “Sweeteners”, “D-Tag”. Another study [11] was performed to investigate acute Tis review included clinical interventions in animals and efects on blood sugar levels in 8 healthy individuals and in humans, as well as studies on the formulation and production 8 individuals with DM 2, afer the oral intake of 75 g of D- offoodthatcontaintagatose.TesearchincludedEnglishand tagatose (D-tag) alone and combined with 75 g of glucose. Spanish as languages. Diabetics received separately and at 0, 10, 15, 20, and 30 min 75gofD-tag,30minutesbeforeadoseof75gofglucose. 3. Tagatose and Blood Glucose Oral load with D-tag did not alter blood sugar levels or insulininanygroup.Tepretreatmentwith75gofD-tag A phase II study with more than 6 months of duration and attenuated the glycemic curve in diabetics [11], signifcantly a phase III efectiveness study with more than 12 months of reducingthebloodglucoseareaunderthecurve(AUC) duration used D-tag to reduce HbA1c in 161 and 494 diabetic and the glycemic increment afer the ingestion of glycoside patients, respectively, in the United States and India. Te solution [11]. Gastrointestinal adverse efects caused by high results showed a statistically signifcant reduction in HbA1c doses of D-tag suggest that this may act to reduce intestinal compared to the placebo group, concluding that it could glucose absorption. eventually become a treatment for diabetes [10]. In another randomized research [12] whose main objec- A cross, randomized, double-blind experimental design tive was to evaluate the safety and efect of D-tag on the determined the supplementation efect with tagatose on glycemic control in patients with DM 2 according to levels of postprandial hyperglycemia in 85 Korean hyperglycemic glycosylated hemoglobin (HbA1c) at the end of 6 months with individuals (�=52and �=33) [1] (Table 1). Blood samples diferent doses of D-tag, 2.5 g, 5.0 g, or 7.5g (3 times/day), were taken during fasting and afer drinking a beverage with controlling the serum level of blood glucose, plasma lipids, sucralose-erythritol (placebo) and other formulation with HbA1c, changes in body weight, and body mass index, as tagatose at 0, 30, 60, and 120 minutes, analyzing glucose, well as insulin variations [12], basal glycaemia dropped in insulin, C-peptide, and lipid profle [1]. Hyperglycemic indi- 3 and 6 months just in the group that received a dose of viduals of legal age had higher levels of triglycerides, Col- 7.5 g. Te average body weight dropped directly in greater total, LDL-Col, A1, and B apolipoprotein. Afer the intake of a proportion to doses of 5.0 g and 7.5 g of D-tag. Te minimum BioMed Research International 3 satiety, and insulin secretion [11]. In this sense, the capacity D-tag Glucose of tagatose to increase GLP-1 secretion is highly relevant to the lowering of blood glucose. D-tag is reported to stimulate GLP-1 to a comparable degree to fructose, whereas it did not stimulate GIP [11]. Because neither fructose nor tagatose is sodium-glucose cotransporter-1 (SGLT1) substrate, it follows that signaling pathways other than SGLT1 are likely to be Intestinal involved in GLP-1 secretion. Te exposure of poorly absorbed disaccharidases sugars to the distal gut, with the production of short- chain fatty acids by bacterial fermentation, may represent an important mechanism of GLP-1 stimulation [14]. Xylose, a poorly absorbed pentose, is a potent stimulus for GLP-1, andtagatosemayactinasimilarmanner,givenitsrelatively low absorption rate (∼25%).
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